Primary Care Appointment Completion Rates and Telemedicine Utilization Among Black and Non-Black Patients from 2019 to 2020.
Telemed J E Health
; 2022 May 02.
Article
in English
| MEDLINE | ID: covidwho-2160905
ABSTRACT
Objective:
To understand how differences in primary care appointment completion rates between Black and non-Black patients changed in 2020 within the context of the COVID-19 pandemic and when telemedicine utilization peaked. Materials andMethods:
We conducted a retrospective cohort study using the electronic health record from January 1 to December 31, 2020, among all adults scheduled for a primary care appointment within a large academic medical center. We used mixed-effects logistic regression to estimate adjusted appointment completion rates for Black patients compared with those for non-Black patients in 2020 as compared with those in 2019 within four time periods (1) prepandemic (January 1, 2020, to March 12, 2020), (2) shutdown (March 13, 2020, to June 3, 2020), (3) reopening (June 4, 2020, to September 30, 2020), and (4) second wave (October 1, 2020, to December 31, 2020).Results:
Across 1,947,399 appointments, differences in appointment completion rates between Black and non-Black patients improved in all time periods +1.4 percentage points prepandemic (95% confidence interval [CI] +0.8 to +2.0), +11.7 percentage points during shutdown (95% CI +11.0 to +12.3), +8.2 percentage points during reopening (95% CI +7.8 to +8.7), and +7.1 percentage points during second wave (95% CI +6.4 to +7.8) (all p-values <0.001). The types of conditions managed by primary care shifted during the shutdown period, but the remainder of 2020 mirrored those from 2019.Discussion:
Racial differences in appointment completion rates narrowed significantly in 2020 even as the mix of disease conditions began to mirror patterns observed in 2019. Conclusions and Relevance Telemedicine may be an important tool for improving access to primary care for Black patients. These findings should be key considerations as regulators and payors determine telemedicine's future.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Type of study:
Cohort study
/
Observational study
/
Prognostic study
Language:
English
Journal subject:
Medical Informatics
/
Health Services
Year:
2022
Document Type:
Article
Affiliation country:
Tmj.2022.0104
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